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Monday, September 22, 2008

If I can do it, why can't you?

Every year in my residency program, we are given what is basically a "practice board exam". It is hyped up as being extremely important--something that the program uses to judge its residents and something that fellowships might ask to see. We were told that if we did well, it would make our program look good compared to others, so "make sure you do good". Eep, pressure!

During my first year of residency, I was going to be 39 weeks pregnant when this three-hour exam was scheduled. Considering the importance attributed to this exam, I asked the female program director if I could either be exempt from the exam or take it under circumstances more comfortable for a woman who was nine months pregnant, since three hours straight in a tiny desk with a hard wooden chair did not sound tempting.

Before I conclude this little anecdote, I want to say that I bet I know what some of you are thinking. You're thinking, "What's the big deal? I took my REAL board exam while nine months pregnant, also while breastfeeding a one year old, and pumping during my 15 minute breaks. Also, I had eclampsia at the time and was actively seizing. And I didn't complain."

Admit it, that's what some of you are thinking.

Which isn't so far off from the response I got from my program director, who was the mother of three small children. She told me (via email), "We'll see. I was still answering pages when I was in active labor."

I'm not as strong as all that. When the epidural went in, my pager went OFF.

Still, this incident made me aware of the fact that while other physician mothers ought to be our greatest advocates, sometimes they are our worst enemies. There's a general thought from some female physicians: "If I did it, then why can't you??" I think we've all had encounters with physicians mamas who showed a surprising lack of understanding, sometimes even worse than the men.

I'm guilty of it too. When other women with kids take off a day because their child is sick, I automatically think, "Well, I came to work when my daughter was vomiting." Or when another resident started her maternity leave a whopping month prior to her due date, I couldn't understand why she was unable to work till the very last day, like I did.

And I hate myself for thinking that way. Female physicians should support each other and work together to foster understanding and acceptance of things like maternity leave or having non-insane hours that allow us to spend time with our kids. Everyone is different and just because we were able to work until the last day of our pregnancy or pop back to work three weeks after delivery or have a nanny that never calls in sick, that doesn't mean we shouldn't stand up for other women who might not be exactly like us.

11 comments:

I am on month #6 of pregnancy #3. My first 2 pregnancies, I worked until the day of delivery and thought pregnancy was easy-breezy (I remember taking pride in how stupidly easy my pregnancies were - like it was a skill or something). However, this pregnancy has been so much harder than the first two - more pain, more exhaustion, more "pregnancy-moments". I am requesting an extended maternity leave to start a month early b/c I seriously question whether I'll even make it that far along or if I'll just wake up one morning and say "forget it. Just reschedule everyone b/c I absolutely cannot move my gravid body into work today".

I had my baby 7 weeks ago, which made me pregnant for the better part of my last year of residency. In my program we don't have a single university hospital, so we moved from place to place. Some places were more pregnant-resident friendly than others. At some of the sites, I had to perpetually remind them that I'd rather not be in a room with continuous flouroscopy whenever possible. Or find someone who realized that pushing the 300+ pound patient in the ICU bed was not something a 6 month pregnant woman can handle by herself.

I was lucky, at least the female attendings I worked with had some sympathy. The residents, on the other hand, were not always so nice. The scary part is that the pregnant residents in our program get nothing that remotely resembles preferential treatment - same call amounts until we go on maternity leave, if we take more than 4 weeks (our allotted vacation time) we extend our residencies, and even when someone's on maternity leave it amounts in very little extra call (and it's always at our easy on-call sites, the ones with home call).

"When the epidural went in"? Heck, my husband called the service before we left for the hospital to tell them not to call me for 6 weeks. Can't say anybody would be safe answering pages in active labor. We really ought to be better to each other. Heaven knows the rest of the world won't be.

It's tough game I admit and one I have actively tell myself not to get caught up in. It's all ego. Patting ourselves on the back telling everyone how hard we work and then how hard they should work. They should be ashamed of themselves.

As physician we need to remind ourselves and our colleagues to be easy on themselves, take time to enjoy life and most of all enjoy our families and turn off the pager.

I gave up being the world's hardest doctor for my kids' sake. And I've never regretted it!

Tigermom: I think a lot of it has the culture of all of medicine, which is that since *I* did it, you have to do it. The same way the old school docs who did 40 hour calls feel like the new residents have it too easy, the moms who worked until they were crowning (especially those who didn't have many alternative options) feel like everyone else should have to do the same.

This rings so true to me: I'll be taking the "real" boards for my specialty at 37 weeks... I feel your pain!! At least they're giving me some extra bathroom breaks [with a note from my ob/gyn of course - because, you know, emergency physicians need an obstetrician to tell them that an 8 mo. pregnant woman would need to pee a little more often ;)].

Thanks as always for the blog entries, though - you have no idea how much sustenance you (and everyone else here) provide!

Fizzy, your topics and posts are just so TRUE. This reminded me of the time the OB/gyn chief resident when I was a student rebuked me for pumping milk in a tucked-away area. Better to persecute than support, seemed to be her attitude. Why are women sometimes so horrible to each other? :(

Mothers in Medicine is a group blog by physician-mothers, writing about the unique challenges and joys of tending to two distinct patient populations, both of whom can be quite demanding. We are on call every. single. day.

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